The US healthcare industry is making a definite shift towards value-based care, where the quality of healthcare delivered to patients and the results achieved take center stage, marking a clear departure from the traditional fee-for-servicess approach.

The US healthcare industry utilizes Prior Authorization as a means of ensuring optimal and cost-effective use of medical services in accordance with the insurance coverage of each patient. As a rule, healthcare providers must reach out to and obtain approval from the respective insurance companies before they can deliver certain medical treatments or services to their patients.

Hospitals seeking to optimize their revenue cycle and improve their financial performance must start with a foundation of meaningful KPIs. Benchmarking and strategic metrics for each KPI are crucial aspects of implementing an effective transformation.

The brass-tack discussion at the Health Evolution Summit 2023, a gathering of industry leaders, recently delved into the topic of financial transformation in healthcare.